Omeprazole (20 mg) daily given in the morning or evening: a comparison of effects on gastric acidity, and plasma gastrin and omeprazole concentration

Abstract

SUMMARY Although omeprazole has a long duration of action and has usually been given in the morning, there are theoretical advantages in administering antisecretory drugs in the evening as has been shown for the H2‐receptor antagonists. The aim of this study was to compare the effects of placebo and 20 mg omeprazole given either in the morning or evening, on gastric acidity, plasma gastrin levels and plasma omeprazole in 6 duodenal ulcer patients. The 24‐hour mean pH (± S.E.M.) was: placebo 1.7 ± 0.1; morning doing, 3.9 ± 1.8 (P < 0.01); evening dosing, 2.9 ± 1.1 (N.S.). There was a large inter‐individual variability of intragastric acidity in response to omeprazole, which was reflected both in the plasma gastrin and in the area under the plasma omeprazole concentration–time curve. Morning administration of omeprazole is optimal, but variability in the patient response to 20 mg omeprazole is still seen.

Chronic rhinosinusitis and bacterial biofilms

“…dosing, for instance, have uniformly demonstrated significant failure rates [40,41]. The average morning dose of a PPI has been shown to last an average of only 13.8 h [42] whereas an evening dose lasts an even shorter 7.5 h [43]. Most current treatment trials therefore suggest a need for b.i.d.…”

Comparison of the effects of fasting morning, fasting evening and fed bedtime administration of tenatoprazole on intragastric pH in healthy volunteers: a randomized three‐way crossover study

“…2 In addition, it has been shown that morning administrations of first-generation PPIs achieved a better acid suppression than evening dosing. 3 The recommended time of dosing of these drugs, able to optimize their pharmacokinetics (PK) and hence their acid-suppression effect and clinical response, has then been defined as being before breakfast, with at least 1 h time lapse for esomeprazole. 2 The PPIs are essentially irreversible inhibitors: the duration of their activity is therefore much longer than their plasma half-life, sufficient for them to be recommended and approved as once a day medication.…”

The effect of time‐of‐day dosing on the pharmacokinetics and pharmacodynamics of dexlansoprazole MR: evidence for dosing flexibility with a Dual Delayed Release proton pump inhibitor

“…[18][19][20][21][22][23] Study designs were varied, but results generally showed either no difference in pharmacodynamics between morning and evening dosing 22,23 or better gastric acid control with morning dosing.…”